WTC Visual Survey Form 100% 1 B14
Pr Ise Address:
74i A 70 - FUL uN SYREE1
Block: Residential 0 Commercial j 1 Name of Building:
Lot Mix Use 0 Other
# of Stories: AKA's:
Building Owner/Management: S s Telephone Number. ( jZ) 26_ 22o
Name: po,.i —,v FAX: ( )
Address:
On Site Contact:
Name: ' Telephone Number: ( )
Building Owner Management Activities
Interior Survey Performed ❑ Yes ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up ❑ Yes ❑ No Locations:
ACM Clean Up ❑ Yes ❑ No Locations:
Air Monitoring ❑ Yes ❑ No Locations:
Copies of All Reports and Data Requested Yes
Visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A Yes ❑ No 51No Visible/Fine Layer ❑ % to 1" ❑ > 1"
South 0 N/A El Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
East ❑ N/A ® Yes ❑ No ® N&Visibfe/Fine Layer ❑ Y2 to 1" ❑ > 1"
West 0 N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"
Facade Description:
Roof
Debris: %2 to 1" 0>1"
Description: y ee e- i 2..0 02.
Setbacks N/A ❑
Floor: Debris: ❑ No Visible/Fine Layer ❑ Ya to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1"
Comments
Date: 2_/ 1c /2002 Inspection Team: Name: R A—f>? yr 4,6W Agency:
Name: Agency:
NYC-WTC 000129356
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000129356Source: NYC Law Department, mirrored locally
WTC debris inspection form documenting visual inspection results for facade condition, ACM assessment, and building characteristics for a 3-story structure.